Perioperative oxytocin infusion versus tranexamic acid and ethamsylate in reducing intraoperative blood loss during caesarean section: a systematic review and meta-analysis


Objective. Review the efficacy of tranexamic acid and ethamsylate (TXAEth) infusion compared to oxytocin in reducing intraoperative blood loss during caesarean section.
Materials and Methods. Studies reporting TXAEth efficacy compared to oxytocin published up to November 24, 2023, were systematically searched across PubMed, EBSCOHost, and ProQuest. Three researchers independently extracted data. The extracted data were analysed using the MedCalc v19.5.1.
Results. In this meta-analysis, three articles were assessed involving 463 participants. There was a significant mean difference in intraoperative blood loss (p = 0.030, 95%CI 0.117-2.272) and postoperative haematocrit (p = 0.004 (95%CI -8.916 to -1.710). There was no significant mean difference in the duration of surgery (p = 0.058, 95%CI -0.012-0.739) and postoperative haemoglobin (p = 0.197 (95%CI -2.026 to 0.418).
Conclusions. Our studies demonstrate that using TXAEth reduced intraoperative bleeding and lowered haematocrit changes among participants. However, preoperative TXAEth has no significant advantage over the oxytocin group in terms of either the duration of surgery or postoperative haemoglobin.

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